Editor, Editors, USER, admin, Bureaucrats, Check users, dev, editor, founder, Interface administrators, oversight, Suppressors, Administrators, translator
10,784
edits
Difference between revisions of "Logic of medical language"
no edit summary
| Line 178: | Line 178: | ||
==Final Considerations== | ==Final Considerations== | ||
The role of language in diagnosis is a critical issue in medicine. Diagnostic accuracy heavily relies on precise communication between healthcare providers and patients, as well as among clinicians. This is where the ambiguity and vagueness of medical language become particularly problematic.<blockquote>The ICD-9 (International Classification of Diseases) lists 6,969 disease codes, which increased to 12,420 in the ICD-10<ref name=":0">{{Cita libro | autore = Stanley DE | autore2 = Campos DG | titolo = The Logic of Medical Diagnosis | url = https://pubmed.ncbi.nlm.nih.gov/23974509/ | opera = Perspect Biol Med | anno = 2013 }}</ref>. While this expansion reflects the increased complexity of modern medical practice, it also highlights the challenges in standardizing diagnostic criteria. The large number of codes underscores the need for precise terminology and unambiguous language, as even slight misunderstandings can lead to misclassification of diseases and, consequently, incorrect treatments.</blockquote><blockquote>Studies estimate that diagnostic errors contribute to 40,000 to 80,000 deaths annually in the United States alone<ref>{{Cita libro | autore = Leape LL | titolo = What Practices Will Most Improve Safety? | anno = 2002 }}</ref>. These errors often stem from misinterpretations of clinical signs, ambiguous language in medical records, or misunderstandings between doctors and patients. As a result, both over-diagnosis and under-diagnosis become common, increasing the risk of inappropriate treatments or failure to provide necessary care.</blockquote>To address these challenges, | The role of language in diagnosis is a critical issue in medicine. Diagnostic accuracy heavily relies on precise communication between healthcare providers and patients, as well as among clinicians. This is where the ambiguity and vagueness of medical language become particularly problematic.<blockquote>The ICD-9 (International Classification of Diseases) lists 6,969 disease codes, which increased to 12,420 in the ICD-10<ref name=":0">{{Cita libro | autore = Stanley DE | autore2 = Campos DG | titolo = The Logic of Medical Diagnosis | url = https://pubmed.ncbi.nlm.nih.gov/23974509/ | opera = Perspect Biol Med | anno = 2013 }}</ref>. While this expansion reflects the increased complexity of modern medical practice, it also highlights the challenges in standardizing diagnostic criteria. The large number of codes underscores the need for precise terminology and unambiguous language, as even slight misunderstandings can lead to misclassification of diseases and, consequently, incorrect treatments.</blockquote><blockquote>Studies estimate that diagnostic errors contribute to 40,000 to 80,000 deaths annually in the United States alone<ref>{{Cita libro | autore = Leape LL | titolo = What Practices Will Most Improve Safety? | anno = 2002 }}</ref>. These errors often stem from misinterpretations of clinical signs, ambiguous language in medical records, or misunderstandings between doctors and patients. As a result, both over-diagnosis and under-diagnosis become common, increasing the risk of inappropriate treatments or failure to provide necessary care.</blockquote>To address these challenges, Charles Sanders Peirce's triadic approach{{Tooltip|2=Let's consider a patient, Mr. Rossi, who presents with symptoms of facial pain and difficulty chewing. These symptoms can be interpreted in various ways depending on the specialist's expertise: a dentist might consider them indicative of temporomandibular disorder (TMD), while a neurologist could interpret them as neuropathic pain.'''Coding Symptoms:''' Symptoms:<math>S_1</math>: Facial pain and <math>S_2</math>: Difficulty chewing. Diagnoses: <math>D_1</math>: Temporomandibular Disorder (TMD) and <math>D_2</math>: Neuropathic Pain (nOP) {{Tooltip|(Mathematical Formalism) | We can formalize the process of decoding symptoms using a conditional probability function. Let’s define <math>P(D | S)</math> as the probability of a diagnosis <math>D</math> given the presence of symptoms <math>S</math>. <math> | ||
P(D | S) = \frac{P(S | D) \cdot P(D)}{P(S)} | |||
</math> where: <math>P(D | S)</math> is the Probability of diagnosis <math>D</math> given symptoms <math>S</math>, <math>P(S|D)</math> is the Probability of observing symptoms <math>S</math> if diagnosis <math>D</math> is true, <math>P(D)</math>: is the Prior probability of diagnosis <math>D</math> and <math>P(S)</math> is the prior probability of observing symptoms <math>S</math>. | |||
''Practical Application:''' Let’s assume that: The dentist estimates <math>P(S | D_1) = 0.8</math> (80% probability of observing symptoms with diagnosis TMD); The neurologist estimates <math>P(S|D_2)= 0.5</math> (50% probability of observing symptoms with diagnosis nOP) and The prior probability of TMD is <math>P(D_1) = 0.3</math> and for nOP is <math>P(D_2) =0.2</math>. Now, we calculate <math>P(S)</math>: <math> P(S) = P(S | D_1) \cdot P(D_1) + P(S | D_2) \cdot P(D_2)</math> | |||
<math>P(S) = 0.8 \cdot 0.3 + 0.5 \cdot 0.2 = 0.24 + 0.1 = 0.34</math> Now we can calculate <math>P(D_1 | S)</math> and <math>P(D_2 | S)</math>: <math> | |||
P(D_1|S) = \frac{P(S | D_1) \cdot P(D_1)}{P(S)} = \frac{0.8 \cdot 0.3}{0.34} \approx 0.706 | |||
</math> and <math>P(D_2 | S) = \frac{P(S | D_2) \cdot P(D_2)}{P(S)} = \frac{0.5 \cdot 0.2}{0.34} \approx 0.294 | |||
</math> |2}} '''Interpretation:''' In this example, the probability of a diagnosis for TMD is approximately 70.6%, while for neuropathic pain it is about 29.4%. This demonstrates how symptoms can be "decoded" to arrive at a more accurate diagnosis, highlighting the need to interpret the body's signals within the context of clinical communication and interdisciplinary knowledge. This practical application of the metaphor of encrypted machine language illustrates the complexity of the diagnostic process and the importance of clear and precise communication between patients and healthcare providers.}}—abduction, deduction, and induction—offers a robust framework for improving diagnostic reasoning. In Peirce's model, abduction is the process of generating hypotheses based on observed signs and symptoms. Deduction involves deriving specific predictions from these hypotheses, while induction tests the hypotheses through further observation or experimentation<ref>{{Cita libro | autore = Vanstone M | titolo = Experienced Physician Descriptions of Intuition in Clinical Reasoning: A Typology | url = https://www.degruyter.com/document/doi/10.1515/dx-2018-0069/pdf | anno = 2019 }}</ref>. This approach emphasizes the importance of careful reasoning in the diagnostic process and highlights how linguistic precision is vital for accurate medical decision-making. | |||
Furthermore, modern diagnostic processes increasingly rely on machine language and non-verbal signals, especially in the era of digital health technologies. Electrophysiological tests, imaging results, and genetic data are forms of "machine language" that require interpretation by clinicians. While these data streams provide invaluable insights, they also add layers of complexity to the diagnostic process, particularly when combined with vague or ambiguous verbal reports from patients. As such, a clinician must integrate both verbal and non-verbal information to form a holistic understanding of a patient's condition. | |||
In this chapter, we explored the complexities of medical language and its implications for clinical diagnosis. We also introduced the concept of "'''encrypted machine language''' {{Tooltip|2=Let's consider a patient, Mr. Rossi, who presents with symptoms of facial pain and difficulty chewing. These symptoms can be interpreted in various ways depending on the specialist's expertise: a dentist might consider them indicative of temporomandibular disorder (TMD), while a neurologist could interpret them as neuropathic pain.'''Coding Symptoms:''' Symptoms:<math>S_1</math>: Facial pain and <math>S_2</math>: Difficulty chewing. Diagnoses: <math>D_1</math>: Temporomandibular Disorder (TMD) and <math>D_2</math>: Neuropathic Pain (nOP) {{Tooltip|(Mathematical Formalism) | We can formalize the process of decoding symptoms using a conditional probability function. Let’s define <math>P(D | S)</math> as the probability of a diagnosis <math>D</math> given the presence of symptoms <math>S</math>. <math> | |||
P(D | S) = \frac{P(S | D) \cdot P(D)}{P(S)} | |||
</math> where: <math>P(D | S)</math> is the Probability of diagnosis <math>D</math> given symptoms <math>S</math>, <math>P(S|D)</math> is the Probability of observing symptoms <math>S</math> if diagnosis <math>D</math> is true, <math>P(D)</math>: is the Prior probability of diagnosis <math>D</math> and <math>P(S)</math> is the prior probability of observing symptoms <math>S</math>. | |||
''Practical Application:''' Let’s assume that: The dentist estimates <math>P(S | D_1) = 0.8</math> (80% probability of observing symptoms with diagnosis TMD); The neurologist estimates <math>P(S|D_2)= 0.5</math> (50% probability of observing symptoms with diagnosis nOP) and The prior probability of TMD is <math>P(D_1) = 0.3</math> and for nOP is <math>P(D_2) =0.2</math>. Now, we calculate <math>P(S)</math>: <math> P(S) = P(S | D_1) \cdot P(D_1) + P(S | D_2) \cdot P(D_2)</math> | |||
<math>P(S) = 0.8 \cdot 0.3 + 0.5 \cdot 0.2 = 0.24 + 0.1 = 0.34</math> Now we can calculate <math>P(D_1 | S)</math> and <math>P(D_2 | S)</math>: <math> | |||
P(D_1|S) = \frac{P(S | D_1) \cdot P(D_1)}{P(S)} = \frac{0.8 \cdot 0.3}{0.34} \approx 0.706 | |||
</math> and <math>P(D_2 | S) = \frac{P(S | D_2) \cdot P(D_2)}{P(S)} = \frac{0.5 \cdot 0.2}{0.34} \approx 0.294 | |||
</math> |2}} '''Interpretation:''' In this example, the probability of a diagnosis for TMD is approximately 70.6%, while for neuropathic pain it is about 29.4%. This demonstrates how symptoms can be "decoded" to arrive at a more accurate diagnosis, highlighting the need to interpret the body's signals within the context of clinical communication and interdisciplinary knowledge. This practical application of the metaphor of encrypted machine language illustrates the complexity of the diagnostic process and the importance of clear and precise communication between patients and healthcare providers.}}" a metaphor for the ways in which the human body communicates information through symptoms and signs that must be decripted. In future chapters, we will delve deeper into the logic of medical language, examining how time, logic, and the concept of assembler codes can be used to improve diagnostic accuracy. These discussions will be crucial in understanding how medical practitioners can mitigate the effects of ambiguity and vagueness in clinical communication, ultimately leading to more precise and effective patient care. | |||
{{Bib}} | |||